| Kristin's Story | |
Kristin O'Meara is a freelance writer who has subclinical hypothyroidism. She was diagnosed in April of 2001, and has volunteered to share her story as a case study in order to help others dealing with this problem.
 | After one month of treatment on Levoxyl, life was better, but still not back to normal. Since January, I'd been to five general practitioners, four of whom were in the same practice. Doctor #1 had said motherhood had worn me down, and told me to take Vitamin C. Doctor #2 gave me a blood test after my husband and I pushed him to the wall, then disappeared. Doctor #3 had made the diagnosis, but couldn't explain why I had begun to have heavy, frequent periods every two weeks as soon as I started taking Levoxyl. |
Doctor #4 had dropped in to take questions on the phone from time to time, but hadn't really treated me directly. Just for an outside evaluation, I saw Doctor #5, who validated the treatment with Levoxyl, but also gave me Prozac, which I tossed in the garbage.
What's more, I had even wackier symptoms than before I started taking Levoxyl. My skin breaking out like wild, and my face looked like it was morphing into a topographical map of the Andes. My scalp was itchy and dry. I changed soaps, moisturizers, shampoos and conditioners. Nothing seemed to work. Even though I had more energy overall, and could get through the day whole without crashing for a nap, my energy level was different and strange. I sometimes felt short of breath, even when walking along at a slow pace. As a woman who had always been very physically active, I was frightened by the sensation of having to concentrate on breathing.
My right thumb, which had been numb since January, had not regained full sensation, despite regular physical therapy and chiropractic treatment for degenerated discs. Every time that I went to the gym, my legs felt like lead by the end of my workout. As a person who regularly whizzed through 40-, 50- and 60-minute cardio sessions, I was now barely hanging on through 30 minutes. My feet, especially my right foot, felt weak and sore, and by the end of the day, I would sit with it propped on pillows. It felt flat, like someone had let the air out of my arch.
I was sure that all my efforts to lose weight by working out harder had done some damage. I chided myself for being so vain that I had actually hurt myself trying to lose weight. And, although my weight gain had stopped, I couldn't shave off a pound. Not one. Sure, from week to week there would be fluctuations, and one happy day, I thought I'd managed to finally lose two pounds I practically danced home from the gym, imagining that I'd finally made a breakthrough. But, a week later, the weight was back.
With all of the ups and downs since my diagnosis, things often seemed laughably absurd. I searched books and the Internet for answers, so many symptoms appeared to be associated with hypothyroidism that it seemed almost ludicrous. My husband and I had a running joke: If one of us lost our car keys, spilled coffee or had some other minor mishap, we'd look at each other gravely, then flatly intone, "it must be hypothyroidism."
But there were plenty of good things happening. On most days, I felt ok. I woke up awake, not tired. I started to have a sense that a fog was lifting. I also felt like I'd missed out on some good times, especially those with my young daughter. In the three years since her birth, it seemed, I had been just getting through most days, and, although I always felt like I would run through fire for her, I hadn't really appreciated her the way I did now.
This year, spring seemed brighter and springier. I spent whole days cruising around with her in the car, like Thelma and Louise without handguns. We'd hit the library and the park, make day trips to visit friends, go out for lunch or just sit in the grass together. There was a lot of giggling. It was great.
At first it seemed that she had suddenly become much more fun, but eventually I realized that she'd always been great. I was the one who'd been out of sorts, and I'd probably been a real drag to hang around with. Of course, just in time to kill my buzz, I got my period again, for the third time in six weeks. This time, it lasted 17 days, four of which were among the most uncomfortable days I've had since I recovered from a C-section in 1998. I decided that I'd call the diagnosing physician, Doctor #3, just to see what she said about this. I knew I'd have to go through Nurse Cranky Pants again just to get her on the phone, but I was calm and persistent, despite her huffy tone when I requested a phone conference with the doctor. My call went unanswered that day, so I called again the following day. No answer. I finally got audibly, righteously, snottily mad later that day, and demanded to speak with the doctor immediately. I was put on hold. Then, a very annoyed voice came on the line; it was Doctor #3. "I don't know why you're having your period so often," she snapped. "You should call your gynecologist and set up an appointment, because you might have an underlying [gynecological] problem that they need to address."
"But I'm taking a hormone, and Doctor #4 [Doctor #3's boss] said that the Levoxyl could cause this change. Besides, it's been six weeks since I started taking this medicine, and I'm totally drained by all the bleeding. I'd like to test my TSH now, instead of in two weeks."
"Fine," she said, "I'll get the lab paperwork ready."
Within minutes, I got in my car, picked up the lab papers and drove to the testing clinic. Two days later, I got a message on my answering machine from Nurse Cranky Pants. "Your bloodwork looks normal. Doctor #3 isn't in, but Doctor #4 looked at your results and says you should keep taking your Levoxyl."
"No way," I thought. "I'm personally keeping the OB Tampon people in business. You take my Levoxyl."
I called back Nurse Cranky Pants, and said, "please fax me the test results."
Apparently, she'd had enough of my uppity behavior, and snarkily said, "I told you, your tests were normal."
I said, "I'm taking these tests to another doctor, could you please fax them now?"
A few minutes later, my results arrived. My TSH was 2.65. The numbers were better. I grudgingly called the gynecologist who delivered my daughter and spoke with his kind and motherly nurse about my menstrual woes. Immediately, she said, "of course the medication could affect your period! You're medicating your thyroid, and the thyroid governs everything!"
I felt vindicated. And, with that, Doctors #1 through #4 were permanently kicked to the curb.
Just for the heck of it, I posted a message on the hypothyroidism forum on About.com before going to bed that night night. I asked if anyone else had experienced heavier, longer periods after starting Levoxyl. The next day, a woman replied that the exact same thing had happened to her.
"PMS one week, period the next," she wrote. "I started on Armour Thyroid, and within one month, I was back to normal."
It was my situation, almost to the letter. I was so grateful, I could've hugged her. Soon, several others explained that their periods had changed after starting the medication. I decided to read more about Armour, and bought Dr. Broda Barnes' book, called "Hypothyroidism, the Unsuspected Illness." The late doctor was an advocate of natural thyroid medicines. In it, he described all my symptoms in vivid detail, all problems stemming from hypothyroidism. He included a whole chapter on menstrual difficulties, and I began to realize that all the strange and inexplicable problems I had in the past might be related to an undetected thyroid imbalance. His book was chock full of information on the drug.
Despite the fact that it was dessicated pig thyroid -- which icked me out a bit -- I was heartened to read that natural thyroid had been in use for decades. Many patients who had used Armour for years had flatly refused to switch to other medications, according to Dr. Ridha Arem's "The Thyroid Solution." Unlike Levoxyl, which is a synthetic, T4-only preparation, Armour has T4 and T3. Instead of hoping my body could convert Levoxyl's T4, the T3 in Armour would already be available for use by cells throughout my body. The proportion of T4 to T3 in Armour wasn't exactly the same as in a human body, but in my view, it was close enough to do some good.
As I scanned the Armour-related posts on About.com, I realized that getting a prescription might not be so easy. Most doctors seemed to prefer Synthroid, and other T4 drugs, the folks on the forum said. So, nearly two months into my treatment with Levoxyl, I girded for battle.
I had seen Doctor #5, a GP with my gynecologist's practice, early on in my treatment with Levoxyl. Although I was shocked and dismayed when she had said my symptoms were caused by depression, I decided that she'd seemed the most willing to listen, and gave her one more shot. I made an appointment. Then, I started highlighting passages in books, printing out information from the Internet and making a case for the use of Armour Thyroid. I also wrote a letter. In it, I chronicled every symptom and every reaction, both positive and negative, relating to my course of treatment with Levoxyl. For the coup de grace, I brought pictures of my former healthy self, fitting into my old size-8 shorts, just nine months after my daughter's birth. Seeing those picture set off a twinge of sadness in me. Less than three years had passed, I thought, but in those years, I'd changed so much.
When Doctor #5 met with me, she was visibly surprised by the onslaught of information I had brought, as I went through my manifesto point by point. As she had in the last visit, Doctor #5 listened intently and made notes as I spoke. As I handed her a copy of my three-page letter, she said, "I'm still not sure that it's possible that your symptoms can be caused by such a low level of hypothyroidism, because the Levoxyl has brought your TSH into the normal range. However, I am willing to give Armour a try if you think it will help."
That was all I needed to hear. Side by side, in the doctor's office, I sat with Doctor #5 and did the conversion equation to determine the right dosage of Armour. When I left her office, prescription in hand, I walked out into a bright, sunny afternoon.
OK, I thought. Hopefully this will work.
